7 Comments

About Hydroxychloroquine. The Chinese study was a tiny one (about 30 each in both the treatment and the control groups) and the entry criteria was that the patients did not have fever, that is that they were either asymptomatic or minimally symptomatic. In the treatment arm, about 5 went on to more severe symptoms (not described how severe), with about 15 in the control group. While this represents about an 80% v 50% outcome difference in this specific samples, as trumpeted by Peter Navarro this morning, the idea that these statistics provide even tiny support for opening the floodgates to its general use, is ludicrous. Similarly with the original French clinical study, with a French followup study showing no drug benefit. The original impetus for using this drug was based on lab, non-clinical research; there is currently not much more justification for its use.

And what is there to lose? For one thing, despite the the federal government encouraging an increase in the drug's production, there are already patients with rheumatologic disease who have worsened because they can't get the HC that had kept them well.

More than that, while its side effects can be fairly well monitored in the relatively small number of outpatients who had been using it, monitoring outpatients is a very different situation when it's being given out like it's Vitamin C. In the ICU patient, blood chemistry is complicated under the best of circumstances, with imbalances that can promote life-threatening heart rhythm disturbances. Hydroxychloroquine makes situation even more complex and therefore more dangerous.

Bear in mind that Hydroxycloroquine has now been used as a salvage on hundreds of patients in the last few weeks. Considering the crush of cases around the world, if it was a "game changer" for this infection, we would have not the very rare clinical supporter of its use, but a chorus of ICU docs screaming about its effectiveness.

Does Hydroxychloroquine have clinical utility as a prophylactic drug? Is it useful for mild, moderate or severe cases? If it has substantial utility, the professionals, desperate for actually useful tools, will make that clear in short order. Otherwise, it's hucksters selling fish tank cleaner.

Expand full comment

We all know why CQ/HCQ is more talked about then the other treatments.

Expand full comment

Any redactions incoming?

Expand full comment

I do an update on all sorts of newsletters - and this will def be a topic we revisit!

Expand full comment

Hey Tangle man, what about doing some research on medrxiv.org. There are many serious studies that shows how useful HCQ is against covid-19. Don't make it a politicised debate. Just a science one.

Expand full comment